Aspiration After Congenital Heart Surgery

Area of Science:

• Pediatric Cardiology
• Pediatric Surgery
• Swallowing Disorders

Background:

• Dysphagia and vocal cord dysfunction are frequent complications following congenital heart surgery.
• These conditions increase the risk of aspiration, potentially leading to pneumonia, lung disease, and respiratory arrest.

Purpose of the Study:

• To implement and evaluate a protocol for the early detection of aspiration in high-risk infants post-congenital heart surgery.
• To assess the prevalence of vocal cord dysfunction and aspiration in this cohort.

Main Methods:

• Retrospective data collection from infants under 120 days old undergoing specific congenital heart surgeries (Norwood, aortic arch repair, Blalock-Taussig shunt, ECMO cannulation).
• Postoperative assessments included symptom evaluation, fiberoptic endoscopic evaluation of swallowing (FEES), and modified barium swallow (MBS) prior to oral feeding.
• Comparison of patients with and without aspiration.

Main Results:

• Of 96 patients, 33% showed vocal cord dysfunction (FEES) and 51% had aspiration (FEES or MBS).
• Most aspirating patients (73%) were asymptomatic, and 53% had normal vocal cord function.
• Aspiration is common, and isolated assessments may lead to underdiagnosis.

Conclusions:

• A comprehensive protocol utilizing both FEES and MBS is essential for early detection of vocal cord dysfunction and aspiration.
• This approach may prevent adverse outcomes in high-risk postoperative pediatric patients.